Project summary/abstract Approximately 5,000 adolescents ages 14 to 18 years will be diagnosed with cancer each year in the US and an estimated 80% will become long-term survivors. Adolescent cancer long-term survivors have some of the highest risks for treatment-related late effects, predisposing them to cancer-related morbidity and early mortality, as well as negative psychosocial and developmental outcomes. A particularly challenging time for adolescent survivors and their parents is end-of-treatment. End-of-treatment means the adolescent is no longer receiving treatment, and interactions with health care providers become much fewer and less frequent for adolescents and parents. End-of treatment presents intense challenges for adolescents and their parents, but a paucity of studies have described adolescent or parent's experiences at this juncture. The specific aims of this pilot study are to: 1) Describe and compare the worries, perceived challenges, and ways of managing these issues for adolescent cancer survivors (14 to 18 years) and their parents at end-of-treatment and follow- up; 2) Describe the behavioral-emotional functioning of adolescents and parents' anxiety at end-of-treatment and follow-up; and 3) Evaluate the effectiveness of the study's protocol for recruitment of adolescent-parent dyads. Forty participants (20 adolescents, 20 parents) will be recruited from a Comprehensive Cancer Center in the Pacific Northwest. Two subgroups will be recruited: 1) adolescents with acute lymphoblastic leukemia and non-Hodgkin's B-cell lymphoma and their parents and 2) adolescents with solid tumors, Hodgkin's disease, and other non-Hodgkin lymphomas and their parents. Semi-structured telephone interviews will be conducted separately for adolescents and parents within one month of the end-of-treatment and at three and six months. Content analysis with inductive coding will be used to analyze the interview data. Standardized questionnaires will be used to measure adolescents' emotional-behavioral functioning and parental anxiety. Study findings will inform the eventual development of a larger extramural grant and an adolescent-parent intervention to improve end-of-treatment transition. This study will be the first important step in addressing the health and developmental needs of adolescent cancer survivors and their parents after treatment.